Diagnosis Flashcards
1
Q
How to make a dx of Migrains w/o aura
A
2:
-unilateral
-pulsating
-mod/sever
-avoidance of activity
1:
-N/V
-photo/phonaphobia
2
Q
how to make dx of migraines w/aura
A
only have to have 2 HA with clear aura descritpion
3
Q
when is prophylatic migrane meds used
A
with 4+ migrains per mo
4
Q
Mainstay of migrane prevention
A
-lifestyle mods
-BBlockers
5
Q
Prophylactic migrane meds
A
-bblockers
-trycyclic antidepressants
-topamax
-depakote
6
Q
Go to abortive migraine tx
A
-asa
-tylenol
-caffine
then triptans
7
Q
Inflammatory markers of are elevated with temporal arteritis
A
crp and esr
8
Q
How to treat temporal arteritis
A
long term steroids 1-2 yrs
symptoms typically resolve quick
9
Q
Prophylatic drug for cluster HA
A
verapamil
10
Q
cluster HA attack abortives
A
-High flow O2
-imitrex
11
Q
A thunder clap headache is often associated with
A
stroke
12
Q
what are some residual SE of TIA
A
-paralysis
-aphasia
13
Q
Treatment for bells palsy
A
-steroid within 72hrs
-antivirals
-eye ointment
14
Q
What type of tremor is present with parkinson
A
resting
15
Q
when do essential tremmors occur
A
-occurs with intent
16
Q
treatment of essential tremors
A
-bblockers
-regular physical activity
17
Q
Why is ropinirol useful in parkinson
A
useful for tremors
18
Q
SE of consussion
A
-HA
-Dizziness
-confusion
-sleepiness/lethargy
19
Q
treatment for mild concussions
A
-decrease screen time
-rest
-slowly return to activity
20
Q
potential complications of severe concussions
A
-hypoxia
-internal bleeding
-death
21
Q
when is MS frequently dx
A
20-40yo
22
Q
pts with MS are at an increased risk of
A
trigeminal neuralga
23
Q
how to treat MS
A
-specialist- DMARDs
24
Q
S/S of MS
A
-muscle weakness
-balance issues
-incontinence
-vision complaints (often presenting symptom)
25
what causes meninigitis
-bacterial
parasite
-virus
26
S/S of meningitis
-flu like at first (fever, fatigue, body aches)
Then get much sicker:
-confusion
-difficulty walking
-skin rashes
-vomiting.anorexia
-c/o severe HA
-stiff neck
27
Compications of meningitis
-seizures
-hearing loss
-memory issues
-learning issues
-shock/death
28
how to dx meningitis
-lumbar puncture (WBC and bacteria in fluid)
29
absence seizures common in
kids (often accused of daydreaming)
30
how to dx absence seizures
eeg but hard to catch
31
S/S of absence seizures
look off and blankly stare for 20-30s or eye flutter
32
Tx of absence seizure
-outgrow
33
Tonic clonic seizure
grandmal
34
tonic phase
stiffening
35
clonic phase
jerking
36
how long do grandmals last
3 mins
(911 if longer than 5)
37
SNRI examples
-duloxetine
-venlafaxine
38
SSRI examples
-fluoxetine
-praoxetine
-sertraline
39
Fluoxetine
-jittery
-long half life
40
paroxetine
-sedating
-jittery
41
escitalopram
-quick
-good for anxiety
42
sertraline
-good for elderly (low SE)
43
three categories of insomnia
transient <1w
Short term 2-3mo
chronic 3mo+
44
Non-benzo sleep meds
-ambien
-lunesta
45
benzo sleep med
xanax
46
non-modifiable HTN risks
-old
-black
-male
-family hx
47
S/S HA
-fatigue
-HA
-Vision changes
48
Normal BP AHA
<120/80
49
Elevated BP AHA
120-129/<80
50
Stage one BP AHA
130-139/80-89
51
Stage two AHA
140+/90+
52
Goal AHA
<130/80
53
What are three microvascular complications with HTN
-retinopathy
-nephropathy
-neuropathy
54
groups that benefit from statins
-high ASCVD risk
-Prior cardiac event
-LDL >190
-DM
-40-75yo
55
low intensity stating
-pravastatin
-simvastatin
56
What will CK/CR be in rhabdo
5-10x normal
57
what causes atypical PNE or "walking pne"
mycoplasma (milder but more persistant)
58
what causes typical pne
streptococcus PNE
59
avoid what when treating pne
cough suppresants (expectorants ok)
60
When to FU pne
8w FU CXR
61
what is >10 on the CAT assessment
significant daily disruption due to COPD
62
Group A
CAT <10
0-1 exacerbations
63
Group A tx
ONE bronchodialator
-SABA- albuterol
or
-LABA- Formoterol
64
Groub B
CAT >10
0-1 exacerbations
65
groub B tx
LABA or LAMA (tiotropium)
66
group c
CAT <10
Many exacerbations
67
group c tx
LAMA (tiotropium)
(could also do LABA+LAMA)
68
Group D
Cat >10
Many exacerbations
69
group d tx
LABA plus LAMA
REFER to PULM
70
mild COPD exacerbation treatment
-saba
71
moderate COPD exacerbation treatment
SABA + abx/steroids (macrolide or tetracycline)
72
Severe COPD exacerbation treatment
admit
73
Fev1 of >80
intermittent or mild persistnt
74
fev1 60-80
moderate
75
fev1 <60
severe (refer)
76
step 1
FEV1 >80%
Symptoms <2x/mo
ICS-LABA PRN
77
step 2
Fev1 >80%
symptoms >2x/mo but not daily
ICS daily
78
Step 3
FEV160-80
symptoms most days NA x1weekly
ICS LABA daily or ICS w/LTRA (singular)
79
Step 4
Fev1<60
Refer
Medium ddose ICS daily
80
who is SLE most common in
women of child bearing age 15-45
81
symptoms of SLE
vague
-fatigue
-joint pain
-mental fog
82
11 criteria of which 4 must be present for SLE
-malar rash
-discoid rash
-photosensitivity
-oral/nasal ulcers
-arthritis
-cardio/pulm complaints
-renal complaints
-neuro complaints
-immuno disorders
-+ ANA
-heme disorders
83
what do we need to watch for with lupus
proteinuria
84
intital old folk levothyroxine dose
12.5-25
85
initial adult levothyroxine dose
25/50
86
What is myxedma coma
Severe hypothyroid emergency
87
s/s of myxedma coma
-low temp
-swelling
-confusion
-lethargy
-difficulty breathing
-coma/death
88
Which medication can precipitate myxedma coma
-lithium
-amiodarone
89
hyperthyroidism complications
-heart disease/hf
-osteoporosis
-infertility
90
S/S of thyroid storm
-hyperthermia
-tachy
-HTN
91
cause of thyroid storm in hyperthyroidism
-infection, trauma, radioactive iodine
92
starting metformin dose
500
93
dialysis at what gfr
<15
94
BUN is affected by
-hydration and liver
95
normal HBG
12-18
96
normal HCT
36-54%
97
causes of iron deficiency in kids <1yr
cows milk
98
how is hep b transmitted
-blood
-semen
-body fluid
99
s/s of hep b
-abdominal pain
-fatigue
-dark urine
-nausea
-jaundice
100
hep b tx
-often resolves on own but can be chronic
101
PrEP
-prevention meds
102
PEP
post-exposure meds
103
gold standard HIV screening
HIV1/HIV2 antigen antibody immunoassay
(alsa and western blot old)
104
normal CD4 count
500-1600
105
CD4 to start antivirals
350 or less
106
Diagnostic aides CD4
200 or less
107
macrocytic anemias are always
normochormic
108
where is malaria found
tropical warm african counteries
109
how is malaria spread
inscect bites
110
s/s of malaria
-fever
-fatigue
-HA
-malaise
-joint aches
-n/v
-INCREASED BILI
111
treatment for active malaria infection
-chloroquine
-malarone
112
Prevention malaria med
-atovaquone/proguanil (malarone)
-Cloroquine
113
How is chloroquine taken
weekly
114
How is Malarone taken
daily
115
Which malaria drug is ok in pregnancy
chloroquine
116
Issue with chloroquine
doesnt work on all tipes of malaria
117
issue with malarone
harsh on kidneys
118
how to dx malaria
blood test (parasitic)
119
HOw long is malaria incubation period
6-18 days
120
GERD s/s
-sore throat
-regurgitation
-cough
-chest pain
121
risk factors for GERD
-smoking
-obesity
-pregnancy
-aging
122
two types of PUD
-doudenal
-gastric
123
causes of PUD
-NSAID overuse
-H. pylori
aggrivating factors
-stress
-smoking
-alcohol
124
s/s of doudenal ulcer
-pain RELIEVED by eating
-pain occurs 1-3hrs after eating
125
s/s of gastric ulcer
pain is increased by eating
126
best way to dx h.pylori
fecal antigen is best
127
other ways to dx h.pylori
-urea breath test (easy and cheap but must stop h2/ppi for 2weeks)
-Serum antibody test (will be positive if you have ever had it)
128
how to treat PUD if no by h. pylori
H2 or PPI
129
causes of pancreatitis
-alcoholism
-gallstones (block CBD)
-Increased Ca+ levels
-Increased triglycerides
130
s/s of pancreatitis
-LUQ pain worse when supine
-significant n/v
131
pancreatitis tx
-Treat cause
-Allow pancrease to rest (NPO)
-manage symptoms (pain meds, abx, fluids)
132
most common cause of gastroenteritis
viral
133
S/S of gastroenteritis
-n/v
-diarrhea
-abd pain
-wt loss
-s/s dehydration
134
Tx of gastroenteritis
-FLUIDS
-Antiemetics
-antidiarrheals
-BRAT diet
135
labs for gastroenteritis
-CBC
-CMP
-UA
-STool studies if lingering (occult, cultur, cdiff, ova)
136
Causes of bacterial gastroenteritis
-salmonella
-shigella
-e. colli
-campylobacter
137
TX of bacterial gastroenteritis
-Fluoroquinolone
or
-Macrolide
138
Gardia tx
metronidazole
139
stage one kidney
kidney damage with normal function
GFR >90
140
Stage 2 kidney
mild loss of function
GFR 60-89
141
two asymptomatic kidney stages
1 and 2 CKD
142
Stage 3 kidney
mod-sever loss of function
GFR 39-59
143
Stage 5 CKD
end stage with no urine
GFR <15
144
Stage 4 kidney
severe function loss
GFR 15-29
145
tx of endometriosis
-ocp (decreases growth of endo tissue)
-Meds
-Surgery (removal of endo tissue)
146
symptoms of endometriosis
-debilitating peroids
-irregular cramping
-heavy flow
-anemia
-
147
causes of endometriosis
-Mostly unknonw
-Retrograde menstruation
-surgery (c's, hyster)
-immune disorders
148
complications of endometriosis
-infertility
-increased ovarian and enometrial cancer rates
149
Rotterdam criteria for PCOS dx
-anovulation
-increased androgen levels
-multiple cysts
150
S/S PCOS
-acne
-hirsutism
-acanthosis nigricans
-irregular periods
-wt gain
151
Tx of PCOS
-healty lifestyle choice
-OCP
-metformin
-spirnolactone (suppress androgens)
152
complications of PCOS
-DM
-hyperlipidemia
-HTN
-Increased endometrial CA risk
153
when and how often mammograms
-start at 50-74yo q2yrs
-Not reccomended past 74
154
most common cause of breast lumps
fibrocytic breasts
155
Most common cause of fibrocytic breasts
menstrual cyclet
156
tx of fibrocytic breasts
-OCT pain meds
-US
-Reassess after peroid
157
S/S of fibrocytic breasts lumps
-firm
-tender/sore
-movableR
158
risks for breast CA
-No kids/no breastfeeding
-sedentary lifestyle
-age
-genetics
159
S/S breast CA
-fixed painless lumps
-dimpling
-read flakey nipples
-discharge
160
average age menstrual cycle
12yo
161
primary amenorrhea
no peroid start by age 15
162
secondary amenorrhea
-pregnancy
-underlying causes
163
what is primary dysmenorrhea
no underlying cause
164
what is secondary dysmenorrhea
-cause such as endometriosis or STIs
165
who has dysmenorrhea at higher rates
teens in their first year of peroids
166
tx of dysmenorrhea
-NSAIDS
-Hormonal OCP
167
normal size of prostate
walnut
168
when does BPH usually start
after 50yo
169
What issue do we sometimes see with BPH
bacterial overgrowth in bladder (UTI)
170
what other tests are indicated for prostatitis
-STI
-urine culture
171
S/S prostatitis
-pelvic/abd pain
-dysuria
-nocuturia
-urgency/frequency
172
Treatment for prostatitis
-treat STI
-Levoquin
-bactrim
173
average age prostate CA
66
174
risk factors for prostate CA
-age
-black
-family hx
175
Average age for testicular CA
-young-middle age
176
s/s of testicular CA
-firm, fixed painless nodule
177
s/s of a vericocele
-asymptomatic
-bag of worms
178
what is blanitis
swelling and irritation of the glans penis
179
cause of blanitis
candida most common
180
risk factors for blanitis
-uncircumsized
-poor hygine
-DM
181
s/s blanitis
-erythema
-itching
-pain
-discharge
182
tx for blanitis
-topical antifungal
-culture
183
what is peyronie's disease
curvature of penis as a result of fiborous scar tissue (trauma)
184
S/S of peyronies disease
-painful erection
185
tx for peyronies
uro referral (verapamil injection)
186
risk factor for priapism
sickle cell anemia
187
what can allopurinol do long term
bone marrow suppression -get CBC
188
kyphosis is a late sign of what
osteoporosis
189
what does the ACL do
-stabalizes knee with rotational movement
190
what does the meniscus do
-stabalize knee
-lubricate joint
191
s/s of meniscus tear
"pop" and "lock"
-able to finish game
-delay in swelling over 24 hoursq
192
s/s of ACL tear
-pain occurs after "pop" in less than 1 hour
193
what labs will be elevated with RA
-RF
-ESR
194
tx of RA
-rhuma referral
----DMARDs
195
risk factors for fibromyalgia
-women
-middle aged
-lupus
-RA
196
most common cause of infant dealth
-birth defects
197
most comon cause of kid death
1-4=drowning
teens=MVA
198
Trust v/s mistrust
infants-18mo
knowing needs will be met by caregiver
199
autonomy vs shame
age 3-4
test boundaries,
making choices,
sense of control
200
initiative vs guilt
3-5
learn place in world
asks questions
friendships develope
201
industry vs inferiority
12
comparing self to peers
examining skills
likes/dislikes
202
identity vs role confusion
teens/college
"who am i?"
203
intimacy vs isolation
searching for mate/village
identity development
204
generativity vs stagnation
older adults
need to give back to others
205
integrity vs dispare
being proud of life
206
when do babs return to birth weight
2w
207
roll over
2mo
208
tooth eruption
6mo
209
unilateral hand skill
9mo
210
1-2 mo vax
polio
hib
pne
rota
dtap
211
birth vaccine
hep b
212
6mo vax
flu
213
age for HPV
as early as 9 but 11 is ideal
214
which strains hpv
16/18
warts-6-11
215
when will hemangiomas resolve
by age 4
216
s/s of jaundice in infants
-fussiness
-poor feeding
217
tx varicella-
avoid scratching
antypyretics
callomine lotion/oat baths
218
what can kawaski lead to
aquired heart disease
219
when do molloscum contagiosum resolve
by self in 6-12mo
220
what makes atopic derm worse
-cold
-stress
221
what is scarlatina
the scarlet fever (strep throat) rash
-sandpaper maculopapular rash
222
tx scarlatina
amoxicillin!
223
when would you see palatine petiachea
-strep
224
when will blocked tear ducts self resolve
4-6mo
warm compresses/massage
225
common pathogen for AOM
-strep pne
226
tx of otitis externa
ofloxacin gtts
cortisporin gtts
227
common cause of OExterna
psudomoniasis argulosa
228
when do we start kid BP checks
- birth
-routinely until 3yoa
229
when is fystic fibrosis commonly diagnosed
prior to age 2
230
s/s of CF
-frequent infections
-thick productive cough
-wt loss
-foul/greasy stool
-dyspnea
-salty skin
231
dx CF
-sweat chloride test
-genetic testing
232
tx of RSV
supportive
-antipyretics
-fluids
-monitor RR
233
s/s croup
BARKY COUGH
stridor
fever
234
tx for croup
-dexamethasone
235
when to send croup to ED
-with stridor or severe dyspnea
236
how long are kids contageous with pertussis
2w
237
s/s epiglottitis
-difficulty breathing/swallowing
-stridor.muffled voice
-leaning forward and DROOLING
238
xray with epiglottitis
"thumbprint sign"
239
cause of epiglottitis
HIB
240
what is encopresis
Fecal incont. after successful potty training
241
causes of encopresis
-holding it causing colon to enlarge and desensitize
242
mgt of encopresis
-retrain colon
-fluids, diet, exercise, stool softners
243
when should cryptorchidism self resolve
6mo
244
cryptorchidism most common in
premies
245
s/s vesicouretral reflux
frequent UTI or pylo
246
what is a nephroblastoma
"wilms tumor"
form of renal CA
247
s/s of nephroblastoma
-small abdominal mass that does NOT cross the midline
248
what to do if s/s wilms tumor
-DO NOT PALPATE HARD
-REFER
-us
249
s/s of salter-harris fx
pain
limited ROM
inflammation
swelling
250
what is nursemaids elbow
-radial head sublux
251
tx of nursemaids elbow
-closed reduction in office
252
risk factors for developmental dysplasia of hip
-breech
-female
-family hx
-oligohydramonisis
-1st born
253
when will there be s/s developmental dysplasia of hip
-birth
-up to 1yo
254
tx of developmental dysplasia of hip
-pavlik harness early
-closed reduction and spika cast
255
s/s developmental dysplasia of hip
-asymmetric gleuteal folds
-unequal leg lengths
-abnormal gait/mvt
256
tests for developmental dysplasia of hip
-ortolani and barlows
257
What is legg-galve-perthes disease
osteonecrossis of femoral head
258
when is typical time to find legg-galve-perthes disease
4-8yo
259
dx of legg-galve-perthes disease
-xray or MRI
260
s/s legg-galve-perthes disease
-hip pain
-limp
-positive trendelenbeurg test (cannot stand on one leg without tilting pelvis)
261
tx for legg-galve-perthes disease
ortho referral
262
what is slipped capital femoral epiphysis
when femoral head slips out and damages growth plate
263
s/s of slipped capital femoral epiphysis
-hip pain
-unequal leg lengths
-limp unable to bear wt
-+ trendelenburg sign
264
slipped capital femoral epiphysis dx
xray
265
when does slipped capital femoral epiphysis usually occur
-adolescents
-growth spurts
-trauma
-oesity
266
tx for slipped capital femoral epiphysis
ortho referral
267
when to refer kids with scoliosis
20 degrees plus
268
s/s downs
-flat face
-small lowset ears
-almont eyes
-palmar crease
269
what is turners
when females only have one x
270
what is klinefelter syndrome
when males are born with 2x's which causes testosterone issues
271
s/s of klinefelters
-large head circ
-delayed milestones
-mental disabilities
272
what is spina bifida
neural tube doesnt close right
273
s/s of spina bifida
-sacral dimple or patch of hair
274
tx for febrile seizures
-dont treat no long term damage
275
when to go to ED with febrile seizures
-over 5min
276
Autism screening tool
M-CHAT
277
tx for ADHD
-<6yo CBT
-if over- meds and CBT
278
